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ACUTE ATORVASTATIN RECAPTURE THERAPY IN CORONARY ARTERY BYPASS GRAFTING

https://doi.org/10.20996/1819-6446-2017-13-3-301-308

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Abstract

Aim. To assess the safety of the application of high-dose atorvastatin and its effect on metabolic parameters, such as the total level of nitric oxide and homocysteine in the blood plasma in patients with ischemic heart disease during a coronary artery bypass surgery (CABG).

Material and methods. The study included 42 patients with stable effort angina II-IV functional class. A special criterion for selection was the taking atorvastatin at a dose of 20 mg/day for at least 30 days before patient was directed to surgical revascularization of the myocardium. Immediately before the intervention, the dose of atorvastatin was increased to the maximum allowed with subsequent taking of 40 mg/day. Complications after CABG, indicators of lipid metabolism and biochemical safety of statin use were analyzed. The duration of observation of results of the acute atorvastatin recapture therapy was 3 weeks during hospital period. We used modern enzymatic method for nitrogen oxides determination with the application of nitrate reductase. Determination of total homocysteine was performed by high performance liquid chromatography.

Results. It was found that atorvastatin 80 mg for 12 hours and 2 hours before CABG in patients previously treated with atorvastatin 20 mg/day is well tolerated and leads to decrease in total levels of nitric oxide by 1.6 (0.18-10.8 ) μmol/l and homocysteine by 0.9 (0.17-2.69) μmol/l (p< 0.05 for both)

Conclusion. It is assumed that the metabolic effects of high-dose therapy with atorvastatin may have a positive influence on the immediate postoperative period.

About the Authors

A. V. Panov
Federal Almazov North-West Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Russian Federation
Alexey V. Panov – MD, PhD, Professor, Head of Coronary Heart Disease Research Department


M. L. Gordeev
Federal Almazov North-West Medical Research Centre
Russian Federation
Mikhail L. Gordeev – MD, PhD, Professor, Head of Research Department for Cardiothoracic Surgery


A. A. Zhloba
Federal Almazov North-West Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Russian Federation
Alexander A. Zhloba – MD, PhD, Professor, Head of the Division
of Biochemistry, Research Center


T. F. Subbotina
Federal Almazov North-West Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Russian Federation
Tatiana F. Subbotina – MD, PhD, Professor, Head of Laboratory, Division of Biochemistry, Research Center


I. V. Suhova
Federal Almazov North-West Medical Research Centre
Russian Federation
Irina V. Suhova – MD, PhD, Leading Researcher, Research Department for Cardiothoracic Surgery


M. I. Buthashvili
Federal Almazov North-West Medical Research Centre
Russian Federation
Manana I. Buthashvili – Junior Researcher, Coronary Heart Disease Research Department


I. T. Abesadze
Federal Almazov North-West Medical Research Centre
Russian Federation
Inga T. Abesadze – MD, PhD, Researcher, Coronary Heart Disease Research Department


M. Z. Alugishvili
Federal Almazov North-West Medical Research Centre
Russian Federation
Marianna Z. Alugishvili – MD, PhD, Researcher, Coronary Heart Disease Research Department


N. L. Lohovinina
Federal Almazov North-West Medical Research Centre
Russian Federation
Natalya L. Lohovinina – MD, PhD, Senior Researcher, Coronary Heart Disease Research Department


K. V. Korzhenevskaya
Federal Almazov North-West Medical Research Centre
Russian Federation
Karina V. Korzhenevskaya – MD, PhD, Researcher, Coronary Heart Disease Research Department


M. V. Solovyova
Federal Almazov North-West Medical Research Centre
Russian Federation
Maria V. Solovyova – MD, Cardiologist, Cardiology Department with Rehabilitation Treatment №1


L. V. Mihaylova
Federal Almazov North-West Medical Research Centre
Russian Federation
Lyubov V. Mihaylova – MD, Cardiologist, Cardiology Department with Rehabilitation Treatment №1


E. S. Alekseevskaya
Federal Almazov North-West Medical Research Centre; Pavlov First Saint Petersburg State Medical University
Russian Federation
Elizaveta S. Alekseevskaya – Researcher, Department of Biochemistry, Research Centre


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For citation:


Panov A.V., Gordeev M.L., Zhloba A.A., Subbotina T.F., Suhova I.V., Buthashvili M.I., Abesadze I.T., Alugishvili M.Z., Lohovinina N.L., Korzhenevskaya K.V., Solovyova M.V., Mihaylova L.V., Alekseevskaya E.S. ACUTE ATORVASTATIN RECAPTURE THERAPY IN CORONARY ARTERY BYPASS GRAFTING. Rational Pharmacotherapy in Cardiology. 2017;13(3):301-308. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-3-301-308

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